title: Meta-analysis of temporary versus no clamping in TKA.
abstract: Use of closed drainage systems after total knee arthroplasty (TKA) is a routine practice. Currently, a debate exists regarding whether temporary or no clamping is optimal. A systematic review of the English literature was conducted, and randomized controlled trials comparing all forms of temporary or no clamping drainage were included. Two authors independently extracted articles and predefined data. Data were pooled using a fixed-effects model to perform the meta-analysis. Nine randomized controlled trials totaling 850 patients were retrieved. The results indicate that temporary clamping could significantly reduce the drainage volume, including total drainage volume, drainage volume within 24 hours postoperatively, and drainage volume within 48 hours postoperatively. Furthermore, patients treated with temporary drainage clamping for 4 hours or more had a higher hemoglobin level 24 hours postoperatively than the patients treated with no clamping, and the number of blood transfusions per patient decreased significantly. No significant difference was identified between the 2 practices regarding postoperative range of motion, wound-related complications, and deep vein thrombosis. More randomized controlled trials are needed to provide robust evidence and to definitively determine which practice is most effective in reducing postoperative blood loss.
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People’s Republic of China.
authors.forename: ZeYu
authors.initials: Z
authors.lastname: Huang
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.forename: FuXing
authors.initials: F
authors.lastname: Pei
authors.forename: Jing
authors.initials: J
authors.lastname: Yang
authors.forename: ZongKe
authors.initials: Z
authors.lastname: Zhou
authors.forename: PengDe
authors.initials: P
authors.lastname: Kang
authors.forename: Bin
authors.initials: B
authors.lastname: Shen
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D004322:Drainage / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology* / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome